Success With Penile Vascular Surgery
Recall that reports of vascular surgery indicated phenomenal success rates in the early twentieth century. The fact that you don’t know of anyone who has had one of these operations attests to the fact that they haven’t stood the test of time. In properly selected patients, it is expected that about 50 to 60 percent of these complex operations will result in return of erections. Venous surgery has been even less likely to succeed than arterial bypass. Not to resort to surgery, buy cialis, the strong and reliable medication.
Since a completely normal vascular system (other than the isolated lesion) is needed for the vascular penile operation to be successful, candidates should be selected very carefully. Men with insulin-dependent (Type I) diabetes develop such significant diffuse microvascular disease that they are ruled out almost automatically. Microvascular disease is defined as the selective narrowing of the smaller arteries in the body. Since the pudendal and penile arteries are small arteries, they are affected fairly early in the process. This is the main reason patients with Type I diabetes almost invariably develop erectile dysfunction as well as the reason they aren’t candidates for penile revascularization (although they are good candidates for all the other treatment options).
Men who smoke also develop diffuse arterial disease. For this reason, most surgeons will not consider arterial bypass surgery on anyone still smoking. This is not discrimination; it is simply a realistic view of a patient’s prognosis. It is hard to justify an expensive, risky bypass operation to restore blood flow to the penis in someone who is trying as hard as he can to reobstract the artery.
Men who might be candidates and who stand the greatest chance of success with these uncommon operations are those who are otherwise healthy, but have a solitary area of obstruction. If they are willing to undergo a complex reconstruction, they might be cured.
